当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
6期
37-38
,共2页
李辉%任明亮%刘鹄%刘冬斌%余嘉洪%陈国雄%刘汉辉%周雷
李輝%任明亮%劉鵠%劉鼕斌%餘嘉洪%陳國雄%劉漢輝%週雷
리휘%임명량%류곡%류동빈%여가홍%진국웅%류한휘%주뢰
脊柱退变性疾病%骨质疏松症%可注射骨水泥椎弓根螺钉%椎间融合
脊柱退變性疾病%骨質疏鬆癥%可註射骨水泥椎弓根螺釘%椎間融閤
척주퇴변성질병%골질소송증%가주사골수니추궁근라정%추간융합
Spine degenerative disease%Osteoporosis%Bone cement injectable canulated pedicle screw%Interbody fusion
目的：对比分析可注射骨水泥椎弓根螺钉与传统椎弓根螺钉的脊柱内固定疗效差异，为临床治疗脊柱退变性疾病提供新的思路。方法对116例腰椎管狭窄合并腰椎间盘突出症患者行椎弓根螺钉固定、后路椎间融合术。将患者随机分为试验组(51例，可注射骨水泥椎弓根螺钉)和对照组(65例，传统椎弓根螺钉)。比较两组患者的基本情况、临床效果和影像学结果。结果术后平均随访18个月。试验组优良率为88.2％（45/51），对照组为61.5％（40/65），前者较后者明显升高(P=0.01)。术后1年随访时融合率试验组为84.3％（43/51），对照组为53.8％（35/65），前者较后者明显升高(P=0.003)。两组患者术后椎间隙高度均有不同程度的丢失，试验组1.1(0.6～1.9)mm、对照组4.0(1.9～4.9)mm，但前者丢失程度较后者明显降低(P<0.004)。结论腰椎后路椎间融合手术使用可注射骨水泥椎弓根螺钉较使用传统的椎弓根螺钉能获得更高的临床疗效优良率，同时可以明显促进椎间植骨融合及降低术后椎间隙高度的丢失。
目的：對比分析可註射骨水泥椎弓根螺釘與傳統椎弓根螺釘的脊柱內固定療效差異，為臨床治療脊柱退變性疾病提供新的思路。方法對116例腰椎管狹窄閤併腰椎間盤突齣癥患者行椎弓根螺釘固定、後路椎間融閤術。將患者隨機分為試驗組(51例，可註射骨水泥椎弓根螺釘)和對照組(65例，傳統椎弓根螺釘)。比較兩組患者的基本情況、臨床效果和影像學結果。結果術後平均隨訪18箇月。試驗組優良率為88.2％（45/51），對照組為61.5％（40/65），前者較後者明顯升高(P=0.01)。術後1年隨訪時融閤率試驗組為84.3％（43/51），對照組為53.8％（35/65），前者較後者明顯升高(P=0.003)。兩組患者術後椎間隙高度均有不同程度的丟失，試驗組1.1(0.6～1.9)mm、對照組4.0(1.9～4.9)mm，但前者丟失程度較後者明顯降低(P<0.004)。結論腰椎後路椎間融閤手術使用可註射骨水泥椎弓根螺釘較使用傳統的椎弓根螺釘能穫得更高的臨床療效優良率，同時可以明顯促進椎間植骨融閤及降低術後椎間隙高度的丟失。
목적：대비분석가주사골수니추궁근라정여전통추궁근라정적척주내고정료효차이，위림상치료척주퇴변성질병제공신적사로。방법대116례요추관협착합병요추간반돌출증환자행추궁근라정고정、후로추간융합술。장환자수궤분위시험조(51례，가주사골수니추궁근라정)화대조조(65례，전통추궁근라정)。비교량조환자적기본정황、림상효과화영상학결과。결과술후평균수방18개월。시험조우량솔위88.2％（45/51），대조조위61.5％（40/65），전자교후자명현승고(P=0.01)。술후1년수방시융합솔시험조위84.3％（43/51），대조조위53.8％（35/65），전자교후자명현승고(P=0.003)。량조환자술후추간극고도균유불동정도적주실，시험조1.1(0.6～1.9)mm、대조조4.0(1.9～4.9)mm，단전자주실정도교후자명현강저(P<0.004)。결론요추후로추간융합수술사용가주사골수니추궁근라정교사용전통적추궁근라정능획득경고적림상료효우량솔，동시가이명현촉진추간식골융합급강저술후추간극고도적주실。
Objective To study the curative effects of bone cement injectable canulated pedicle screw versus the traditional pedicle screw in internal ifxation of spine, provide new thinking for clinical treatment of spinal degenerative diseases. Methods 116 patients with adult Lumbar spinal stenosis associated with prolapse of lumbar intervertebral disc were treated with posterior lumbar interbody fusion. The patients were randomly divided into two groups according to the differenced screws used in posterior lumbar interbody fusion. There were 51 patients received bone cement injectable canulated pedicle screw (group A), and 65 patients received traditional pedicle screw(group B). The clinical and imaging results of the patients were compared between the two groups. Results All patients were followed with an average of 18 months The rates of excellent, good and fair were 88.2%and 61.5%in group A and B respectively, group A were signiifcantly higher than that group B (P=0.01). One year post-operatively, the fusion rate were 84.3%and 53.8%in group A and B respectively, group A were signiifcantly higher than that group B (P=0.003). At the last follow up, the average loss of disc space height were 1.1 mm and 4.0 mm in group A and B respectively, group A were signiifcantly lower than that group B (P<0.004). Conclusion Posterior lumbar interbody fusion used bone cement injectable canulated pedicle screw can acquire higher rates of excellent clinical effects, compared to the traditional pedicle screw, meanwhile, promote interbody fusion rate and reduce loss of disc space height signiifcantly.
